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March 24, 2005

When IP kills

Posted by Alan Wexelblat

...and I don't mean that metaphorically. I don't really have the energy for another Big Thoughts post, but this story deserves a lot more thinking than I've been able to give it. So I place it out here for your consideration.

Unless you've been hiding in a hole for the past few years, you are aware that India is the source for generic copies of life-saving anti-AIDS drugs for literally millions of people in the non-industrialized countries. This bill will put a stop to that for new drugs. If you're up on HIV/AIDS thinking, you know that the virus is very good at developing resistance to drugs and a fairly steady flow of new treatments is needed to combat this.

That's not hysteria. MSF is not some radical anti-WTO group, nor a radical anti-intellectual property organization. They're a group of doctors, on the ground in dozens of countries, treating millions of HIV/AIDS patients for whom the steep drop in prices over the past few years, as Indian-made high quality generics have become widely available, has meant a new lease on living. Raise the prices even a trivial amount (by Western standards) and you put them out of reach of hundreds of thousands of people, not to mention stalling out efforts to get the drugs to millions more who need them.

Now we face the issue - is this an appropriate use of intellectual property protections? Does the right of a corporation to make a profit for its shareholders trump the right of these people to live for a few more years with their disease kept in check? I hate questions like that.

Drug companies pull out the "funding research" card. It is true that income from patented drugs funds research. It also funds a massive advertising and lobby machine. Last I looked, US drug industry spending on advertising exceeded spending on R&D by a significant fraction. On the other hand, I do not believe that public need destroys business considerations completely. I choose to invest my money in companies that behave in what I consider socially responsible fashion, but I agree there are other ways businesses can operate.

A balance is needed. I'm not comfortable with the mental image of lavish boardrooms and skyrocketing company profits (they're consistently the most profitable industry in the US) as a shining metal beacon in a sea of dark-skinned misery, death, and suffering. Conversely, I'm not comfortable with the notion of a national government appropriating the fruits of labor (corporate or individual) because it has determined that these fruits meet a real human need.

And I hate not having an inkling of how to get progress on this issue at a pace that has even a glimmer of hope of keeping up with this global pandemic.

Even if most companies should not normally be required to be socially responsible, drug companies and some others are not "most companies". You cannot take your business elsewhere, to a more socially responsible company, legitimately because they have a state sanctioned monopoly. Patents, copyrights, and any other such state sanctioned monopolies are a privilege that should therefore come with a corresponding responsibility -- a legal responsibility to be worthy custodians for their so-called "intellectual property". Besides eventually releasing the thing into the public domain, and ensuring a (non-DRM-encumbered!) copy exists to be released at that time, they should be required to be socially responsible (although exactly how to turn this into legal language is left as an exercise for the reader). Drug companies, especially, should be required to let people have drugs at cost if they are medically necessary and otherwise unaffordable, patents be damned.

My mother-in-law works for an arthritis/rheumatology doctor. I am simply, completely flabbergasted by the amount of money that's spent by drug reps. The whole office regularly has catered lunches, the amount of swag-with-drug-names-on't could fill a landfill (and sooner than later does, because it's mostly useless). My mother worked for a free clinic, and they convinced a few reps to focus on free samples rather than crap, to some effect. I think my mother-in-law's office has, too, but it's less effective when you have potential paying customers there.

Any other business I've worked in (and, being generic-IT, it's been a few) we've had very tight caps on what we can and can't accept from reps. Maybe I'm just not seeing it because I'm not in the business directly, but it sure seems like a gaping hole in ethics there.

I'd be *real* curious to see how "funding research" really compares to "funding the advertising/freebies" in any given drug company's budget.

Karen, you should read some of Robin Cook's novels. One of them in particular mentions drug companies doing the same stuff -- huge expensive wine-n-dining of doctors, and so forth. That one is titled "Mindbend" and it's scary as hell.